ECG of the Week – 14th May 2018 – Interpretation

This ECG is from a 68 yr male who presented with 24 hours of dysponea and palpitations.No past medical history of note and he takes no regular medications.

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Things to think about

What are the key ECG features ?

What are the potential reversible causes for these features ?

How would you manage this patient ?

﻿Rate:

Ventricular rate 42 bpm

Atrial rate 84 bpm

Rhythm:

Regular atrial and ventricular activity

2:1 AV block

Axis:

Normal

Intervals:

PR – Normal (~200ms)

QRS – Prolonged (140ms)

Additional:

RBBB Morphology

Prominent T wave lead III in relation to QRS height

Interpretation:

2:1 AV Block

What happened ?

The patient was admitted under the cardiology team and telemetry revealed intermittent variable AV block (2nd and 3rd degree) and he underwent an uneventful dual chamber PPM insertion.References / Further Reading